Influence of isotretinoin on nasal mucociliary clearance and lung function in patients with acne vulgaris

Abstract

Retinoids are widely used to treat acne in patients with underlying systemic diseases. We evaluated the effect of 13-cis-retinoic acid (isotretinoin) on nasal mucociliary clearance and pulmonary function tests (PFTs) in patients with severe acne vulgaris. Each side effect was scored using a 4-point scale. Mucociliary clearance was evaluated by the saccharin test (ST). ST and PFTs were performed on all patients before and during the third month of treatment. A total of 40 acne patients (88% female, mean age 25 +/- 7 years) were included. The most common side effects were dryness, chapped lips, and xerosis. Mild epistaxis occurred in 13 patients; only two patients reported bleeding more than 10cc. There was no difference before and during the third month of treatment in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, forced expiratory flow rate between 25% and 75% of FVC (FEF(25-75)), and their predicted percentage ratios. Mean nasal mucociliary clearance time was 12.6 +/- 4.1 min before and 15.9 +/- 5.7 after treatment (P < 0.001). We found that nasal clearance was significantly prolonged with treatment, and there was significant correlation between drug dose and mucociliary clearance time. Isotretinoin caused signs and symptoms of dry nose and disturbed mucociliary clearance without affecting PFTs. Nasal complications generally are not serious, especially when isotretinoin is taken in low doses.

Evaluation of Nasal Mucociliary Clearance, Nasal Obstruction Symptom Evaluation, and Epistaxis Severity Score in Isotretinoin Treatment

“…It can also be preferred in ready-to-use products containing D-panthenol, Vaseline, glycerin, hypertonic solutions, and hyaluronic acid. 12 15.6 171 Brzezinski et al 13 47.2 3525 Gorpelioglu et al 10 40 40 Tasli et al 9 26.2 42 Akman et al 17 2 6 0 Rademaker 18 5.2 1745 This study 59.4 108…”

“…2 The reason of this is that in literature, the nasal dryness is considered to be the underlying mechanism causing the decreased MCT (which is the objective finding of isotretinoin use) and epistaxis (which is the subjective finding of isotretinoin use). 2,9,10,13,14 In our study, epistaxis was evaluated with ESS questionnaire. 15 Five (4.9%) patients had a history of epistaxis in the last 6 months before the treatment, and this number increased to 60 (59.4%) when the treatment was completed (P ¼ .021).…”

Systematic Cell Line-Based Identification of Drugs Modifying <i>ACE2</i> Expression

“…The top up-regulator is panobinostat, an anti-cancer histone deacetylase (HDAC) inhibitor with antifibrotic effects that has been shown to reduced risk of acute respiratory deteriorations [7,8] (Figure 1C, logFC=0.457, P=2.29e-5, adjusted P=7.70e-3). The top down-regulator of ACE2 is isotretinoin, a vitamin A derivative with suggested respiratory side-effects [9] ( Figure 1C, logFC=-0.478, P=1.59e-4, adjusted P=0.036; Supp. Table 1F).…”

Assessment of nasal carriage of staphylococcus aureus in patients with acne vulgaris

“…Bu yapılardaki hasar patojen bakterilere zemin hazırlar 10 . Akne tedavisinde kullanılan sistemik isotretinoine bağlı oluşan kuruluk nedeniyle su ve elektrolit dengesinin bozulduğu dolayısıyla müköz viskozitenin azaldığı ve nazal mukosilier klirensin değiştiği bildirilmiş ve isotretinoin dozu ile nazal klirens testi arasında pozitif korelasyon tespit edilmiştir 11 . Sistemik isotretinoin kullanımına bağlı nasal mukozada squamoz hücre oranında azalma, nötrofilik enflamasyonda artış ve solunum epitelinde reaktif değişiklik tespit edilmiştir 12 .…”